Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms
Carol H Yan, Farhoud Faraji, Divya P Prajapati, Christine E Boone, Adam S DeConde, Carol H Yan, Farhoud Faraji, Divya P Prajapati, Christine E Boone, Adam S DeConde
Abstract
Background: Rapid spread of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and concern for viral transmission by ambulatory patients with minimal to no symptoms underline the importance of identifying early or subclinical symptoms of coronavirus disease 2019 (COVID-19) infection. Two such candidate symptoms include anecdotally reported loss of smell and taste. Understanding the timing and association of smell/taste loss in COVID-19 may help facilitate screening and early isolation of cases.
Methods: A single-institution, cross-sectional study evaluating patient-reported symptoms with a focus on smell and taste was conducted using an internet-based platform on adult subjects who underwent testing for COVID-19. Logistic regression was employed to identify symptoms associated with COVID-19 positivity.
Results: A total of 1480 patients with influenza-like symptoms underwent COVID-19 testing between March 3, 2020, and March 29, 2020. Our study captured 59 of 102 (58%) COVID-19-positive patients and 203 of 1378 (15%) COVID-19-negative patients. Smell and taste loss were reported in 68% (40/59) and 71% (42/59) of COVID-19-positive subjects, respectively, compared to 16% (33/203) and 17% (35/203) of COVID-19-negative patients (p < 0.001). Smell and taste impairment were independently and strongly associated with COVID-19 positivity (anosmia: adjusted odds ratio [aOR] 10.9; 95% CI, 5.08-23.5; ageusia: aOR 10.2; 95% CI, 4.74-22.1), whereas sore throat was associated with COVID-19 negativity (aOR 0.23; 95% CI, 0.11-0.50). Of patients who reported COVID-19-associated loss of smell, 74% (28/38) reported resolution of anosmia with clinical resolution of illness.
Conclusion: In ambulatory individuals with influenza-like symptoms, chemosensory dysfunction was strongly associated with COVID-19 infection and should be considered when screening symptoms. Most will recover chemosensory function within weeks, paralleling resolution of other disease-related symptoms.
Keywords: COVID-19; patient outcomes; smell loss; taste loss.
© 2020 ARS-AAOA, LLC.
Figures
![FIGURE 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/7262089/bin/ALR-10-806-g002.jpg)
FIGURE 2
Temporal association of taste score…
FIGURE 2
Temporal association of taste score and COVID‐19 testing. Spaghetti plot of all COVID‐19–positive…
FIGURE 3
Temporal relationship between olfactory improvement…
FIGURE 3
Temporal relationship between olfactory improvement and clinical improvement following COVID‐19 infection. (A) Histogram…
- Dysgeusia in COVID-19: Possible Mechanisms and Implications.Lozada-Nur F, Chainani-Wu N, Fortuna G, Sroussi H. Lozada-Nur F, et al. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Sep;130(3):344-346. doi: 10.1016/j.oooo.2020.06.016. Epub 2020 Jun 27. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020. PMID: 32703719 Free PMC article. No abstract available.
- Smell and Taste Dysfunction in COVID-19 Is Associated With Younger Age in Ambulatory Settings: A Multicenter Cross-Sectional Study.Izquierdo-Domínguez A, Rojas-Lechuga MJ, Chiesa-Estomba C, Calvo-Henríquez C, Ninchritz-Becerra E, Soriano-Reixach M, Poletti-Serafini D, Villarreal IM, Maza-Solano JM, Moreno-Luna R, Villarroel PP, Mateos-Serrano B, Agudelo D, Valcarcel F, Del Cuvillo A, Santamaría A, Mariño-Sánchez F, Aguilar J, Vergés P, Inciarte A, Soriano A, Mullol J, Alobid I. Izquierdo-Domínguez A, et al. J Investig Allergol Clin Immunol. 2020;30(5):346-357. doi: 10.18176/jiaci.0595. Epub 2020 Jun 17. J Investig Allergol Clin Immunol. 2020. PMID: 32554337
- Taste and Smell Impairment in COVID-19: An AAO-HNS Anosmia Reporting Tool-Based Comparative Study.Sayin İ, Yaşar KK, Yazici ZM. Sayin İ, et al. Otolaryngol Head Neck Surg. 2020 Sep;163(3):473-479. doi: 10.1177/0194599820931820. Epub 2020 Jun 9. Otolaryngol Head Neck Surg. 2020. PMID: 32513096 Free PMC article.
- Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study.Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, Dequanter D, Blecic S, El Afia F, Distinguin L, Chekkoury-Idrissi Y, Hans S, Delgado IL, Calvo-Henriquez C, Lavigne P, Falanga C, Barillari MR, Cammaroto G, Khalife M, Leich P, Souchay C, Rossi C, Journe F, Hsieh J, Edjlali M, Carlier R, Ris L, Lovato A, De Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S. Lechien JR, et al. Eur Arch Otorhinolaryngol. 2020 Aug;277(8):2251-2261. doi: 10.1007/s00405-020-05965-1. Epub 2020 Apr 6. Eur Arch Otorhinolaryngol. 2020. PMID: 32253535 Free PMC article.
- A review of smell and taste dysfunction in COVID-19 patients.Wong DKC, Gendeh HS, Thong HK, Lum SG, Gendeh BS, Saim A, Salina H. Wong DKC, et al. Med J Malaysia. 2020 Sep;75(5):574-581. Med J Malaysia. 2020. PMID: 32918429 Review.
- Aggregate Prevalence of Chemosensory and Sinonasal Dysfunction in SARS-CoV-2 and Related Coronaviruses.Lehrich BM, Goshtasbi K, Raad RA, Ganti A, Papagiannopoulos P, Tajudeen BA, Kuan EC. Lehrich BM, et al. Otolaryngol Head Neck Surg. 2020 Jul;163(1):156-161. doi: 10.1177/0194599820929278. Epub 2020 May 19. Otolaryngol Head Neck Surg. 2020. PMID: 32423285 Review.
- COVID-19: An Overview of SARS-CoV-2 Variants-The Current Vaccines and Drug Development.Bostanghadiri N, Ziaeefar P, Mofrad MG, Yousefzadeh P, Hashemi A, Darban-Sarokhalil D. Bostanghadiri N, et al. Biomed Res Int. 2023 Aug 29;2023:1879554. doi: 10.1155/2023/1879554. eCollection 2023. Biomed Res Int. 2023. PMID: 37674935 Free PMC article. Review.
- Cranial nerve involvement among COVID-19 survivors.Heidari ME, Nazemi P, Feizabad E, Beiranvand F, Afzali M. Heidari ME, et al. Front Neurol. 2023 Aug 4;14:1182543. doi: 10.3389/fneur.2023.1182543. eCollection 2023. Front Neurol. 2023. PMID: 37602247 Free PMC article.
- Long COVID: Complications, Underlying Mechanisms, and Treatment Strategies.Zadeh FH, Wilson DR, Agrawal DK. Zadeh FH, et al. Arch Microbiol Immunol. 2023;7(2):36-61. Epub 2023 May 9. Arch Microbiol Immunol. 2023. PMID: 37388279 Free PMC article.
- Acupoint stimulation for long COVID: A promising intervention:Feng BW, Rong PJ. Feng BW, et al. World J Acupunct Moxibustion. 2023 Jun 1. doi: 10.1016/j.wjam.2023.05.012. Online ahead of print. World J Acupunct Moxibustion. 2023. PMID: 37363407 Free PMC article. Review.
- Persistence of SARS-CoV-2 Antigens in the Nasal Mucosa of Eight Patients with Inflammatory Rhinopathy for over 80 Days following Mild COVID-19 Diagnosis.Costa Dos Santos J, Ximenes Rabelo M, Mattana Sebben L, de Souza Carneiro MV, Bosco Lopes Botelho J, Cardoso Neto J, Nogueira Barbosa A, Monteiro de Carvalho D, Pontes GS. Costa Dos Santos J, et al. Viruses. 2023 Mar 31;15(4):899. doi: 10.3390/v15040899. Viruses. 2023. PMID: 37112879 Free PMC article.
- Research Support, N.I.H., Extramural
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Betacoronavirus / isolation & purification
- COVID-19
- Coronavirus Infections / complications*
- Coronavirus Infections / diagnosis
- Coronavirus Infections / epidemiology
- Coronavirus Infections / physiopathology
- Cross-Sectional Studies
- Female
- Humans
- Male
- Middle Aged
- Olfaction Disorders / diagnosis
- Olfaction Disorders / epidemiology
- Olfaction Disorders / etiology*
- Olfaction Disorders / physiopathology
- Pandemics
- Pneumonia, Viral / complications*
- Pneumonia, Viral / diagnosis
- Pneumonia, Viral / epidemiology
- Pneumonia, Viral / physiopathology
- Prevalence
- SARS-CoV-2
- Taste Disorders / diagnosis
- Taste Disorders / epidemiology
- Taste Disorders / etiology*
- Taste Disorders / physiopathology
- Young Adult
- Full Text Sources
- Other Literature Sources
- Medical
- Miscellaneous
NCBI Literature Resources
The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894
![FIGURE 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/7262089/bin/ALR-10-806-g001.jpg)
FIGURE 3
Temporal relationship between olfactory improvement…
FIGURE 3
Temporal relationship between olfactory improvement and clinical improvement following COVID‐19 infection. (A) Histogram…
- Dysgeusia in COVID-19: Possible Mechanisms and Implications.Lozada-Nur F, Chainani-Wu N, Fortuna G, Sroussi H. Lozada-Nur F, et al. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Sep;130(3):344-346. doi: 10.1016/j.oooo.2020.06.016. Epub 2020 Jun 27. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020. PMID: 32703719 Free PMC article. No abstract available.
- Smell and Taste Dysfunction in COVID-19 Is Associated With Younger Age in Ambulatory Settings: A Multicenter Cross-Sectional Study.Izquierdo-Domínguez A, Rojas-Lechuga MJ, Chiesa-Estomba C, Calvo-Henríquez C, Ninchritz-Becerra E, Soriano-Reixach M, Poletti-Serafini D, Villarreal IM, Maza-Solano JM, Moreno-Luna R, Villarroel PP, Mateos-Serrano B, Agudelo D, Valcarcel F, Del Cuvillo A, Santamaría A, Mariño-Sánchez F, Aguilar J, Vergés P, Inciarte A, Soriano A, Mullol J, Alobid I. Izquierdo-Domínguez A, et al. J Investig Allergol Clin Immunol. 2020;30(5):346-357. doi: 10.18176/jiaci.0595. Epub 2020 Jun 17. J Investig Allergol Clin Immunol. 2020. PMID: 32554337
- Taste and Smell Impairment in COVID-19: An AAO-HNS Anosmia Reporting Tool-Based Comparative Study.Sayin İ, Yaşar KK, Yazici ZM. Sayin İ, et al. Otolaryngol Head Neck Surg. 2020 Sep;163(3):473-479. doi: 10.1177/0194599820931820. Epub 2020 Jun 9. Otolaryngol Head Neck Surg. 2020. PMID: 32513096 Free PMC article.
- Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study.Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, Dequanter D, Blecic S, El Afia F, Distinguin L, Chekkoury-Idrissi Y, Hans S, Delgado IL, Calvo-Henriquez C, Lavigne P, Falanga C, Barillari MR, Cammaroto G, Khalife M, Leich P, Souchay C, Rossi C, Journe F, Hsieh J, Edjlali M, Carlier R, Ris L, Lovato A, De Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S. Lechien JR, et al. Eur Arch Otorhinolaryngol. 2020 Aug;277(8):2251-2261. doi: 10.1007/s00405-020-05965-1. Epub 2020 Apr 6. Eur Arch Otorhinolaryngol. 2020. PMID: 32253535 Free PMC article.
- A review of smell and taste dysfunction in COVID-19 patients.Wong DKC, Gendeh HS, Thong HK, Lum SG, Gendeh BS, Saim A, Salina H. Wong DKC, et al. Med J Malaysia. 2020 Sep;75(5):574-581. Med J Malaysia. 2020. PMID: 32918429 Review.
- Aggregate Prevalence of Chemosensory and Sinonasal Dysfunction in SARS-CoV-2 and Related Coronaviruses.Lehrich BM, Goshtasbi K, Raad RA, Ganti A, Papagiannopoulos P, Tajudeen BA, Kuan EC. Lehrich BM, et al. Otolaryngol Head Neck Surg. 2020 Jul;163(1):156-161. doi: 10.1177/0194599820929278. Epub 2020 May 19. Otolaryngol Head Neck Surg. 2020. PMID: 32423285 Review.
- COVID-19: An Overview of SARS-CoV-2 Variants-The Current Vaccines and Drug Development.Bostanghadiri N, Ziaeefar P, Mofrad MG, Yousefzadeh P, Hashemi A, Darban-Sarokhalil D. Bostanghadiri N, et al. Biomed Res Int. 2023 Aug 29;2023:1879554. doi: 10.1155/2023/1879554. eCollection 2023. Biomed Res Int. 2023. PMID: 37674935 Free PMC article. Review.
- Cranial nerve involvement among COVID-19 survivors.Heidari ME, Nazemi P, Feizabad E, Beiranvand F, Afzali M. Heidari ME, et al. Front Neurol. 2023 Aug 4;14:1182543. doi: 10.3389/fneur.2023.1182543. eCollection 2023. Front Neurol. 2023. PMID: 37602247 Free PMC article.
- Long COVID: Complications, Underlying Mechanisms, and Treatment Strategies.Zadeh FH, Wilson DR, Agrawal DK. Zadeh FH, et al. Arch Microbiol Immunol. 2023;7(2):36-61. Epub 2023 May 9. Arch Microbiol Immunol. 2023. PMID: 37388279 Free PMC article.
- Acupoint stimulation for long COVID: A promising intervention:Feng BW, Rong PJ. Feng BW, et al. World J Acupunct Moxibustion. 2023 Jun 1. doi: 10.1016/j.wjam.2023.05.012. Online ahead of print. World J Acupunct Moxibustion. 2023. PMID: 37363407 Free PMC article. Review.
- Persistence of SARS-CoV-2 Antigens in the Nasal Mucosa of Eight Patients with Inflammatory Rhinopathy for over 80 Days following Mild COVID-19 Diagnosis.Costa Dos Santos J, Ximenes Rabelo M, Mattana Sebben L, de Souza Carneiro MV, Bosco Lopes Botelho J, Cardoso Neto J, Nogueira Barbosa A, Monteiro de Carvalho D, Pontes GS. Costa Dos Santos J, et al. Viruses. 2023 Mar 31;15(4):899. doi: 10.3390/v15040899. Viruses. 2023. PMID: 37112879 Free PMC article.
- Research Support, N.I.H., Extramural
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Betacoronavirus / isolation & purification
- COVID-19
- Coronavirus Infections / complications*
- Coronavirus Infections / diagnosis
- Coronavirus Infections / epidemiology
- Coronavirus Infections / physiopathology
- Cross-Sectional Studies
- Female
- Humans
- Male
- Middle Aged
- Olfaction Disorders / diagnosis
- Olfaction Disorders / epidemiology
- Olfaction Disorders / etiology*
- Olfaction Disorders / physiopathology
- Pandemics
- Pneumonia, Viral / complications*
- Pneumonia, Viral / diagnosis
- Pneumonia, Viral / epidemiology
- Pneumonia, Viral / physiopathology
- Prevalence
- SARS-CoV-2
- Taste Disorders / diagnosis
- Taste Disorders / epidemiology
- Taste Disorders / etiology*
- Taste Disorders / physiopathology
- Young Adult
- Full Text Sources
- Other Literature Sources
- Medical
- Miscellaneous
![FIGURE 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/7262089/bin/ALR-10-806-g003.jpg)
Source: PubMed